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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198021372
Report Date: 01/05/2024
Date Signed: 01/05/2024 12:28:23 PM

Document Has Been Signed on 01/05/2024 12:28 PM - It Cannot Be Edited

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
L.A. DAY CARE-EAST, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754
FACILITY NAME:DE ALWIS AND TENIPITA FAMILY CHILD CAREFACILITY NUMBER:
198021372
ADMINISTRATOR:DE ALWIS, SAVITHRI S.FACILITY TYPE:
810
ADDRESS:TELEPHONE:
(310) 691-4807
CITY:POMONASTATE: CAZIP CODE:
91767
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: 0DATE:
01/05/2024
TYPE OF VISIT:PrelicensingUNANNOUNCEDTIME BEGAN:
08:30 AM
MET WITH:Savithri S De AlwisTIME COMPLETED:
12:45 PM
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Licensing Program Analyst (LPA)Mary Silva conducted an announced Pre-Licensing inspection on this date for the purpose of inspecting the facility to ensure the health and safety standards as required by the regulations governing childcare homes are met for initial licensure. A copy of the Pre-licensing Entrance Checklist for Child Care homes form (LIC 9280) was provided. Fire clearance was granted on 12/06/2023 by L.A. City Fire Department.

LPA met with applicant Savithri De Alwis who confirmed the family members residing in the home, that consists of two adults and no children. Present during this inspection was Applicant. Applicant is requesting a large (14 Capacity) family child-care home license. Per Applicant, operating hours will be Monday to Friday, 6:00AM to 8:00PM, for children being cared for ages, 0 Months to 6 years old.

At 8:30 AM applicant Savithri De Alwis guided the LPA on a tour of the facility, indoors and out indoors. All areas identified on the facility sketch were inspected, including but not limited to, off limit areas. Licensing staff advised that if children bring food from home, it should be properly labeled. Applicant will provide am/pm snacks for children in care. The home was inspected for safety, comfort, cleanness, telephone service via cell phone, heating and ventilation, inaccessibility to poisons, detergents, cleaning compounds, medicines, and hazardous items that can pose a danger to children. LPA observed an inoperable decorative fireplace in the living room, barricaded by a metal shield.

Per applicant there are no weapons or firearms currently in the facility. The backyard is adequately fenced and there are no bodies of water observed on the premises. LPA observed there are age-appropriate toys and equipment for children to play. The back yard has a separate area in front of the garage made inaccessible to the children.
___________________________________Page 1 ________________________________________
SUPERVISORS NAME: Christina Gabelman
LICENSING EVALUATOR NAME: Mary Silva
LICENSING EVALUATOR SIGNATURE: DATE: 01/05/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 01/05/2024
This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)
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STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
L.A. DAY CARE-EAST, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754
FACILITY NAME: DE ALWIS AND TENIPITA FAMILY CHILD CARE
FACILITY NUMBER: 198021372
VISIT DATE: 01/05/2024
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Licensing Program Analyst (LPA)Mary Silva conducted an announced Pre-Licensing inspection on this date for the purpose of inspecting the facility to ensure the health and safety standards as required by the regulations governing childcare homes are met for initial licensure. A copy of the Pre-licensing Entrance Checklist for Child Care homes form (LIC 9280) was provided. Fire clearance was granted on 12/06/2023 by L.A. City Fire Department.

LPA met with applicant Savithri De Alwis who confirmed the family members residing in the home, that consists of two adults and no children. Present during this inspection was Applicant. Applicant is requesting a large (14 Capacity) family child-care home license. Per Applicant, operating hours will be Monday to Friday, 6:00AM to 6:00PM, for children being cared for ages, 0 Months to 6 years old.

At 8:30 AM applicant Savithri De Alwis guided the LPA on a tour of the facility, indoors and out indoors. All areas identified on the facility sketch were inspected, including but not limited to, off limit areas. Licensing staff advised that if children bring food from home, it should be properly labeled. Applicant will provide am/pm snacks for children in care. The home was inspected for safety, comfort, cleanness, telephone service via cell phone, heating and ventilation, inaccessibility to poisons, detergents, cleaning compounds, medicines, and hazardous items that can pose a danger to children. LPA observed an inoperable decorative fireplace in the living room, barricaded by a metal shield.

Per applicant there are no weapons or firearms currently in the facility. The backyard is adequately fenced and there are no bodies of water observed on the premises. LPA observed there are age-appropriate toys and equipment for children to play. The back yard has a separate area in front of the garage made inaccessible to the children.

During the inspection of the interior of the home LPA observed the smoke detector and carbon monoxide were tested and verified to be in operable condition. LPA also observed the required fire extinguisher (2A 10BC) located next to the dining room with a receipt dated 11/21/2023.

___________________________Page 2_______________________________________________
SUPERVISORS NAME: Christina Gabelman
LICENSING EVALUATOR NAME: Mary Silva
LICENSING EVALUATOR SIGNATURE:

DATE: 01/05/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/05/2024
LIC809 (FAS) - (06/04)
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STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
L.A. DAY CARE-EAST, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754
FACILITY NAME: DE ALWIS AND TENIPITA FAMILY CHILD CARE
FACILITY NUMBER: 198021372
VISIT DATE: 01/05/2024
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The areas observed by the LPA and confirmed by the applicant during the inspection, were the:
Areas used by children are: Living Room (daycare room), One Bedroom(daycare room), Family Room, One Bathroom next to the Kitchen, Kitchen, Dining Room, & Back Yard.

Off limits areas are Master Bedroom w/bathroom, 2 bedrooms, garage, front yard. Reminded applicant, rooms that are off-limits need to be made inaccessible during operating hours. The applicant does understand that licensing staff may have access to off-limit areas during the inspection if necessary.

Landlord Consent - The applicant provided proof of control of property.
The applicant obtained a signed Property Owner/Landlord Consent form (LIC 9149).

Infant Care: LPA discussed the safe sleep regulations with applicant and discussed the Child Care Licensing Safe Sleep webpage at: https://www.cdss.ca.gov/inforesources/child-care-licensing/public-information-andresources/safe-sleep, as an additional resource. LPA also informed [applicant, licensee, or facility representative] of the importance of checking for recalled infant devices on the United States Consumer Product Safety Commission (CPSC) website at: https://www.cpsc.gov/, and recommended they register all infant devices with the CPSC to be notified of any recalls on their purchased equipment.

The applicant has completed the required Health and Safety Training 10/29/2023, Nutrition Training and Pediatric First Aid and CPR 12/17/2025. Applicant completed mandated reporter training 08/15/2024. LPA observed there are first aid supplies available on the premises.

Incidental Medical Services (IMS) policy was discussed. For IMS information see PIN 22-02- CCP. When any IMS is provided, a Plan for Providing IMS must be submitted to the Department. The following information regarding ADA was provided: US Department of Justice (USDOJ) toll-free ADA Information Line at (800) 514-0301 (voice) or (800) 514-0383 (TTY) and link to publication: Commonly Asked Questions about Child Care Centers and the ADA, available at: http://www.ada.gov/childqanda.htm.

______________________________________Page 3__________________________________
SUPERVISORS NAME: Christina Gabelman
LICENSING EVALUATOR NAME: Mary Silva
LICENSING EVALUATOR SIGNATURE:

DATE: 01/05/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/05/2024
LIC809 (FAS) - (06/04)
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STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
L.A. DAY CARE-EAST, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754
FACILITY NAME: DE ALWIS AND TENIPITA FAMILY CHILD CARE
FACILITY NUMBER: 198021372
VISIT DATE: 01/05/2024
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At 10:50 am the following was discussed with the applicant:

· Criminal Record Clearance-Applicant was reminded that all adults 18 and over living in the home, persons who provide care and supervision to children, and staff who have contact with children, including employees and volunteers, except as specified in Health and Safety Code section 1596.871, must obtain a criminal record clearance or exemption, or transfer their existing clearance or exemption, prior to initial presence in a licensed Family Child Care Home. A civil penalty of $100.00 minimum/day for a maximum of 5-days or, if the penalty is for a repeat violation, for a maximum of 30-days per person will be assessed if this regulation is violated.

· In the absence of the licensee a qualified adult must be present supervising the children; a qualified adult is an individual who has a valid and current Pediatric First Aid and CPR training, Immunizations (TDAP, MMR, Influenza), mandated reporter training and a valid criminal record clearance associated to the facility license.

· Annual fees must be paid promptly and by the due date or a late fee shall be assessed and/or the License may be terminated.

· The fire extinguisher type 2A-10BC must be serviced annually or as often as necessary. Smoke and carbon monoxide detectors should be checked, and batteries replaced as needed.

· Reporting Requirements: Changes should be reported to the Department as soon as they occur such as construction, remodeling, telephone number changes and/or if you move from your home.

· Reporting Requirements: Any unusual incidents or injuries must be reported to the Department within 24 hours via telephone and within seven (7) days in writing.

· Fire and safety drills must be performed each month and documented for review by the Department.

· Smoking is prohibited in a family childcare homes.

· Children and Staff records must be maintained and updated as needed and must be available for review by the Department. If Children and Staff leave the day care all records must be maintained for 3 years after leaving.

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SUPERVISORS NAME: Christina Gabelman
LICENSING EVALUATOR NAME: Mary Silva
LICENSING EVALUATOR SIGNATURE:

DATE: 01/05/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/05/2024
LIC809 (FAS) - (06/04)
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STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
L.A. DAY CARE-EAST, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754
FACILITY NAME: DE ALWIS AND TENIPITA FAMILY CHILD CARE
FACILITY NUMBER: 198021372
VISIT DATE: 01/05/2024
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·No infant walkers, no Johnny jumpers, no saucer chairs, no trampolines and any other item that falls into those category’s, are not permitted in the facility.

· Inspection Authority: All adults living and working in the home shall be made aware of the Department’s right to inspection of the home, which includes, but is not limited to the right to enter the home when children are being cared for, interview children and adults, review documentation and observe off limit areas if needed.

· The facility license number must be on all advertisements, publications or announcements with the intent to attract clients.

· Isolation for Ill children: When a child is ill he/she shall be separated from other children (reference 102417(e) Operation of a Family Child Care Home).

· Liability Insurance was discussed; LPA advised applicant to review Title 22 Regulation 102417(m)(1) for additional information.

· Immunization Requirement: H&S 1597.622: Commencing September 1, 2016, a person shall not be employed or volunteer at a family day care home if he or she has not been immunized against influenza, pertussis (Tdap), & measles (MMR). The licensee & all adults working with children must have proof of immunizations.

· Mandated Reporter Training: H&S 1596.8662: Beginning January 1, 2018, all licensed providers, applicants, directors and employees are to complete training as specified on mandated reporter duties. Training is available at: www.mandatedreporterca.com

· LPA advised the applicant how to access forms, regulations, and quarterly updates on the Child Care Licensing website at: www.ccld.ca.gov


_____________________________Page 5 ___________________________________________
SUPERVISORS NAME: Christina Gabelman
LICENSING EVALUATOR NAME: Mary Silva
LICENSING EVALUATOR SIGNATURE:

DATE: 01/05/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/05/2024
LIC809 (FAS) - (06/04)
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STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
L.A. DAY CARE-EAST, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754
FACILITY NAME: DE ALWIS AND TENIPITA FAMILY CHILD CARE
FACILITY NUMBER: 198021372
VISIT DATE: 01/05/2024
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At 11:20 am LPA reviewed with applicant the LIC 311D, Forms/Records to Keep In Your Family Child Care Homes, children’s forms/records, facility forms/records, and information to be posted. Entrance Checklist was provided to the applicant.

Community Care Licensing Division (CCLD) regularly sends information to licensed facilities, providers, and stakeholders by way of Provider Information Notices (PIN), Program Quarterly Update Newsletters and other important information communication platforms. To receive important licensed related information to licensed facilities, visit the CCLD Important Information website at https://www.cdss.ca.gov/inforesources/community-carelicensing/subscribe and select the Child Care option to receive email communication. Applicant’s email address was verified/obtained during this inspection. The applicant was advised that the email may be public information.

MyChildCarePlan.org – Applicant was informed of the MyChildCarePlan.org site, a consumer education website that helps families obtain childcare by connecting them to child care providers and Resource and Referral Agencies (R&Rs) throughout California.



On this date, 12/27/23, the California Attorney General - Megan’s Law website was searched for information on sex offenders required to register with local law enforcement under California's Megan's Law. No registered sex offenders were found at the facility addresses. Under state law, some registered sex offenders are not subject to public disclosure; therefore, they may not have been included in this search. However, the Department conducts a monthly cross reference of each address on record for all registered sex offenders against all CCLD facility addresses pursuant to information shared by California DOJ.

The applicant’s signature on this report acknowledges that they have signed the Application for a Family Child Care Home License (LIC 279) under penalty of perjury that the statements on the application and any attachments are correct.

This home currently meets the description of a safe and healthy environment for children as described in Chapter 1, Division 12, Title 22 of California Code of Regulations, and the facility file will be submitted for approval for a large family childcare license. (Capacity 14)

Exit interview conducted and report was reviewed with the applicant Savithri De Alwis.


________________________Page 6_____________________________________
SUPERVISORS NAME: Christina Gabelman
LICENSING EVALUATOR NAME: Mary Silva
LICENSING EVALUATOR SIGNATURE:

DATE: 01/05/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/05/2024
LIC809 (FAS) - (06/04)
Page: 6 of 6